scholarly journals Revisiting the International Classification of Functioning, Disability and Health, a Comprehensive Model for Exploring Disablement in Low- and Middle-income Countries: A Narrative Overview

2021 ◽  
Vol 19 (3) ◽  
pp. 261-272
Author(s):  
Surajo Kamilu Sulaiman ◽  
◽  
Ashiru Hamza Mohammad ◽  
Aminu Alhassan Ibrahim ◽  
Sham’unu Isa Abdu ◽  
...  
Keyword(s):  
Literature Search ◽  
Contextual Factors ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Middle Income ◽  
Research And Practice ◽  
Middle Income Countries ◽  
Low And Middle Income

Objectives: To overcome the inherent limitations of the medical and social models of disability, the World Health Organization developed the first international conceptualization of disability: the International Classification of Functioning, Disability, and Health (ICF). Despite the ICF’s robustness, it is still underutilized in research and practice in Low- and Middle-Income Countries (LMICs). This article discusses the applications, strengths, limitations, and unique considerations when using the ICF to explore disabilities in LMICs like Nigeria. Methods: A literature search was conducted in Medline, CINAHL, Web of Science, AMED, and Google Scholar. Articles were selected if they reported on any of the development, structure, applications, strengths, and limitations of the ICF. The review draws from the selected articles using a narrative discussion. Results: The literature search yielded 22 articles that met the eligibility criteria. The ICF is a classification of components of health and functioning, which views disability as an outcome of a dynamic interaction between a person’s health condition and contextual factors. The ICF was developed cross-culturally; thus, it is applicable in various socio-environmental contexts. However, despite its comprehensiveness, the ICF is criticized for lack of clear theoretical underpinnings, overlapping and redundant components, and absence of systematized personal factors. Discussion: The ICF has brought a significant paradigm shift in the measurement of disability by explicitly recognizing the role of contextual factors in the incapacitation process and placing all health conditions on an equal footing. Hence, stakeholders in disability research and practice in LMICs need to prioritize the ICF over other disablement models.

Parental perspectives of functioning in their children with autism spectrum disorder: A global scoping review

Autism ◽  
2020 ◽  
pp. 136236132095005
Author(s):  
Marisa Viljoen ◽  
Soheil Mahdi ◽  
James Shelly ◽  
Petrus J de Vries
Keyword(s):  
Children With Autism ◽  
Autism Spectrum ◽  
High Income ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

No reviews to date have summarized the views of parents on the functional challenges and/or strengths of their children with autism spectrum disorder. We set out to perform a scoping review aiming (a) to identify and collate global results to provide a broad description of parental perspective of functioning research and (b) to summarize these using the International Classification of Functioning Disability and Health–Child and Youth version framework. The International Classification of Functioning Disability and Health provides a language to describe the functional skills of an individual with a health condition in terms of their body structures, body functions, activities and participation, their environmental and personal factors. Given the influence that context has on functioning, and the potential impact of economic status on availability of resources, we were specifically interested to compare perspectives from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English peer-reviewed studies published between 1990 and June 2016. Articles were accessed and summarized using thematic analysis. Meaningful phrases were extracted from key findings and linked to second-level International Classification of Functioning Disability and Health–Child and Youth categories following international linking rules. Thirty-three studies were identified of which only six originated from low/middle-income countries ( n = 6/33, 18%). Two studies compared perspectives from low-/middle-income countries and high-income countries ( n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth bio-psychosocial framework while functional themes from low-/middle-income countries were predominantly focused on environmental factors. We propose further research should consider a systematic comparison of high-income and low/middle-income countries across functional categories to get a more accurate impression of the impact of context on functioning. Lay abstract No paper to date has summarized parents’ views on the functional challenges and/or strengths of their children with autism spectrum disorder. In this review we set out to perform a scoping review aiming to (a) find and compare existing research from around the globe on parental perception of functioning and (b) summarize results from these papers using the International Classification of Functioning Disability and Health–Child and Youth version framework. Since we know that the place and circumstances we live in can have a significant influence on our functioning in daily life, we were specifically interested in comparing perceptions from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English studies published between 1990 and June 2016. Papers were summarized and key findings were linked to International Classification of Functioning Disability and Health–Child and Youth categories. Thirty-three studies were identified, of which most were conducted in high-income countries ( n = 25/33, 76%) with only six studies in low/middle-income countries ( n = 6/33, 18%). Two studies compared views from low/middle-income and high-income countries ( n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth framework while functional themes from low-/middle-income countries were mostly focused on environmental factors. It was difficult to directly compare studies from low/middle-income and high-income countries because they investigated and discussed such different parts of functioning. We suggest that future research should use an approach that will allow researchers to directly compare functional categories in order to get a more accurate impression of the impact of context on functioning.

scholarly journals Functional gender differences in autism: An international, multidisciplinary expert survey using the International Classification of Functioning, Disability, and Health model

Autism ◽  
2020 ◽  
pp. 136236132097531
Author(s):  
Karl Lundin ◽  
Soheil Mahdi ◽  
Johan Isaksson ◽  
Sven Bölte
Keyword(s):  
Gender Differences ◽  
High Income ◽  
International Classification ◽  
World Health ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Middle Income ◽  
The World ◽  
Health Organization

Few studies have addressed gender differences in autism in relation to functioning and across cultures. We aimed to explore functional gender differences in autism from a multidisciplinary, global perspective using the International Classification of Functioning, Disability, and Health. Perceptions among professionals in high-income countries and middle-income countries were examined based on qualitative survey data from N = 225 professionals. Of these, n = 131 professionals provided information on functional gender differences in autism. Thirty-two professionals reported perceiving no gender differences. Remaining respondents ( n = 99)—representing 31 countries, all World Health Organization regions, and 10 different professions—were included in a content analysis on functional gender differences, which generated three main categories and 13 subcategories. The subcategories were subsequently linked to International Classification of Functioning, Disability, and Health categories. Autistic males were described as displaying more externalizing behaviors, and females as having more internalizing problems and being more socially motivated. Thirty-two International Classification of Functioning, Disability, and Health categories were identified, of which 31 were covered by the comprehensive Core Set for autism. Gender differences in core symptoms and co-existing problems were acknowledged by professionals from both high-income countries and middle-income countries, while differences in social behaviors, including camouflaging, were more frequently described by experts from high-income countries. Lay abstract In this study, we explored if professionals working with autistic people in different regions of the world perceive differences between females and males diagnosed with the condition. A total of 131 professionals responded to a survey that included an open question about gender differences in autism. Of these, 32 responded that they do not perceive gender differences in autism. The information provided by the other 99 experts was analyzed to identify common patterns. Three main differences were found, (1) Matching the clinical conceptualization of autism where professionals described differences in core symptoms of autism, and that autistic females were less similar to the conceptualization of autism. In (2) Co-existing problems, professionals described that autistic males display more apparent problems including hyperactivity, while autistic females were perceived as having more internalizing issues such as anxiety and eating disorders. In the last category, (3) Navigating the social environment, experts perceived autistic females as more socially motivated, and more inclined to camouflage social difficulties, making their challenges less evident. Professionals also perceived differences in the social environment, for example, that autistic girls receive more support from their peers while autistic boys are more often bullied. Our results suggest that professionals working in different parts of the world acknowledge gender differences in autism, but also that there might be some regional differences. Finally, we found that gender differences reported by the international professionals could largely be assessed with a shortened version of the International Classification of Functioning by the World Health Organization, specifically developed for autism.

scholarly journals Factors impacting employment for people with autism spectrum disorder: A scoping review

Autism ◽  
2018 ◽  
Vol 23 (4) ◽  
pp. 869-901 ◽  
Author(s):  
Melissa Scott ◽  
Ben Milbourn ◽  
Marita Falkmer ◽  
Melissa Black ◽  
Sven Bӧlte ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Contextual Factors ◽  
Autism Spectrum ◽  
International Classification ◽  
Spectrum Disorder ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Core Sets ◽  
The Impact

The aim of this study is to holistically synthesise the extent and range of literature relating to the employment of individuals with autism spectrum disorder. Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with autism spectrum disorder employed in competitive, supported or sheltered employment were included. Content analysis was used to identify the strengths and abilities in the workplace of employees with autism spectrum disorder. Finally, meaningful concepts relating to employment interventions were extracted and linked to the International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder. The search identified 134 studies for inclusion with methodological quality ranging from limited to strong. Of these studies, only 36 evaluated employment interventions that were coded and linked to the International Classification of Functioning, Disability and Health, primarily focusing on modifying autism spectrum disorder characteristics for improved job performance, with little consideration of the impact of contextual factors on work participation. The International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder are a useful tool in holistically examining the employment literature for individuals with autism spectrum disorder. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with autism spectrum disorder and the critical need for interventions which target contextual factors if employment outcomes are to be improved.

scholarly journals Participation After Stroke: Do We Understand All the Components and Relationships As Categorised in the ICF?

2012 ◽  
Vol 13 (1) ◽  
pp. 4-15 ◽  
Author(s):  
Melanie Hoyle ◽  
Louise Gustafsson ◽  
Pamela Meredith ◽  
Tamara Ownsworth
Keyword(s):  
Environmental Factors ◽  
Functional Outcomes ◽  
Contextual Factors ◽  
Stroke Care ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Stroke Survivors ◽  
Disability And Health ◽  
Restricted Participation

Although advances in stroke care have been shown to improve functional outcomes and survival, evidence suggests that stroke survivors continue to report restricted participation and dissatisfaction with life after returning home. There remains a need to identify ways to improve participation after stroke, considering the person within their context. The International Classification of Functioning, Disability and Health (ICF) provides a valuable framework that can be useful for categorising key components associated with participation. The two parts of the ICF — (a) Functioning and Disability and (b) Contextual Factors — encourage consideration of the functions/body structures, activity and participation, and personal and environmental factors, respectively. Previous research has identified links between body functions, structures and activity, with increasing attention being given to the ways in which these link with participation. Although some of the components influencing participation poststroke are well defined, there is a need to further develop our understanding of how personal and environmental factors may affect participation. In this article, stroke literature is categorised using the ICF and a range of personal and environmental factors are investigated as potential contributors to levels of participation poststroke. This article concludes that research investigating contextual factors and their interactions with participation is warranted.

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